Thursday, April 02, 2009

We've Come a Long Way . . .

In case you missed it.

Until the Anglican Lambeth Conference in 1930, there was an unbroken and unanimous Christian opposition to artificial birth control. That year the Lambeth Conference declared artificial birth control methods licit in limited situations. We've come a long way in a very short period of time.

The United Church of Christ HIV and AIDS Network announced that it is encouraging condom distribution IN CHURCHES:

Making condoms available at houses of worship and faith-based educational settings provides opportunities to open conversations that can save lives. In this context, condoms become educational tools. Their presence encourages questions and discussions with individuals who are prepared to respond with factual and up-to-date information. Condoms are a sign that people of faith take sexuality seriously as a part of human life and that we endorse all options for preventing HIV infection and other sexually transmitted diseases.

Let me quote:

"Condoms are a sign that people of faith take sexuality seriously . . ."

16 comments:

I would agree that we have come a long way in attitudes about birth control, but we still have far to go, as evidenced by Pope Benedict’s recent pronouncements during his Africa visit.

During an interview en route to Cameroon on March 17, the Pope said that distribution of condoms would not resolve the AIDS problem but, on the contrary, would aggravate it. The Vatican Web site later altered the transcript to have the Pope saying that condoms “risked” aggravating the problem. The scientific consensus about AIDS transmission agrees with the first part of the Pope’s comment while strongly disagreeing with the second part, whichever version we adopt. There is simply no evidence that condom use is aggravating the epidemic.

The United Church of Christ HIV and AIDS Network has simply adopted a policy based on sound science. The Centers for Disease Control and Prevention has posted the following opinion about condoms on its Web site:

Latex condoms, when used consistently and correctly, are highly effective in preventing the sexual transmission of HIV, the virus that causes AIDS.

Another highly reliable and respected source of evidence in health care, the Cochrane Collaboration (www.cochrane.org), has published a meta-analysis of the best studies. Its conclusions are that condoms can reduce the transmission of AIDS by 80 percent.

The Pope is of course correct in stating that abstinence is the best way to prevent transmission. No group maintains that condoms are the whole answer. But most agree that they are a key part of the arsenal.

The UN has predicted that HIV infections in Africa will reach 90 million in just the next 16 years. Eighty million Africans may die from AIDS during that same period. It is now critically important that world leaders of the stature of Pope Benedict align their thinking with reality. A child dying of AIDS is indifferent to questions about its mother’s morality or the decline of Western civilization. Any measure that can reduce its chances of contracting the disease should be adopted without equivocation, based on the best science that is available.

Edward C. Green’s article (The Washington Post, 3/29/09) is entirely consistent with the findings of the Centers for Disease Control and Prevention and the Cochrane Collaboration that I cited earlier. As he says, “condoms have not worked as a primary (italics mine) intervention in the population-wide epidemics of Africa.” But in the next sentence he explains what he means, by quoting from a 2008 article in Science: “Consistent condom use has not reached a sufficiently high level, even after many years of widespread and often aggressive promotion, to produce a measurable slowing of new infections in the generalized epidemics of Sub-Saharan Africa.”

In other words, condoms have failed to slow the spread of AIDS in Africa not because they are inherently ineffective but because they have not been used enough. “In theory,” he says, “condom promotions ought to work everywhere,” and he cites successes in Cambodia and Thailand.

In Africa, condoms have not been as effective as elsewhere because of the “multiple and concurrent sexual networks” that predominate there. The Pope is quite correct to claim that monogamous sex is the best solution to the crisis, and it should certainly be encouraged. But Africans who either cannot or will not remain in mutually faithful relationships should be strongly encouraged to use condoms. It is misguided to take condoms off the table altogether or to suggest that they are ineffective.

Condoms and taking ...sexuality seriously? You can't write this stuff.

I know Gil must maintain a sense of propriety and decorum, but I don't.

I have never used a condom. I never saw "Dallas". I am happy not to need to divorce love from the possibility of life. I find condoms hilarious ("Wait, honey, I've ... almost ... got ... it ... oh, s***, well, surely there's another one in your handbag, right?); which is to say, no one in heat really cares to use one, either.

And, believe it or not, there are millions of hobbits ... sorry, people in America who never will either, thank God.

The United Church of Christ HIV and AIDS Network has simply adopted a policy based on sound science.

I suspect that like most of its positions on ... well, on everything, the United Church of Christ's policy on condoms is purely political. To my knowledge, there is no "sound science" which concludes that UCC members are contracting AIDS at a higher rate than the general population. Handing out condoms at UCC services therefore is like pinning an AIDS ribbon to your chest: a purely symbolic act that establishes your compassionate bona fides.

The underlying problem in Africa is not a lack of condom use, it is a culture of sexual irresponsibility, including serial adultery, especially among men. By focusing on condoms as the solution, one runs the risk of creating a false confidence that the underlying behavior can be pursued or even accelerated without risk. It's called "risk compensation" and Edward C. Green agrees that the evidence shows it is aggravating infection rates in Africa.

Here's Green's quote, sourced: "“There is a consistent association shown by our best studies, including the U.S.-funded ‘Demographic Health Surveys,’ between greater availability and use of condoms and higher (not lower) HIV-infection rates. This may be due in part to a phenomenon known as risk compensation, meaning that when one uses a risk-reduction ‘technology’ such as condoms, one often loses the benefit (reduction in risk) by ‘compensating’ or taking greater chances than one would take without the risk-reduction technology.”

What does Green advise the Obama Administration to do about AIDS prevention in Africa? Precisely what they are guaranteed not to do for the sake of ideology: Stop with the condoms and start teaching monogamy and abstinence. Here's Green's quote on that topic, sourced: "So I would advise Obama, the candidate I voted for, to put more emphasis on prevention, and to face up to the hard realities of the best evidence available to date, which shows that condom promotion, testing and counseling, curing the curable STDs, or any of the other interventions widely endorsed and considered "best practices" always funded have simply not worked in Africa. (It's possible they may work in other regions, like condoms in Thailand, so it's easy for me to be misquoted on something like this.) In a number of studies, these interventions have actually been shown to not work.

The two interventions that work best in Africa are promotion of monogamy and fidelity, and male circumcision. We have even stronger science behind the latter. I assume people know about "the male circumcision factor" these days, so I will not say more here"

Condoms are only one of many risk-reduction technologies. Seat-belts are another example that comes to mind. It is true that the risk reduction achieved through use of seat-belts may be offset by the driver’s “compensation”—his or her willingness to take even further risks because of the sense of security that the seat-belts provide. However, the solution to the “risk compensation” dilemma is not to abandon seat-belts but rather to educate drivers about risk compensation. And that is, in fact, what drivers’ education programs have tried to achieve. Furthermore, they have had significant success in this country and elsewhere. There is absolutely no reason why better education about seat-belts cannot also work in Africa.

The purpose of drivers’ education is to provide training in all the available means of preventing accidents and injuries, and certainly no responsible trainer would suggest that “anything goes” once the seat-belts are securely fastened.

I would think we have a good analogy with condom use here. Taking seat-belts out of cars is simply a move in the wrong direction, as is taking condoms out of circulation in an environment where STDs are spreading rapidly. The public health goal should be to educate people about all the ways in which they can protect themselves and others. Such an educational program will necessarily include information about the limitations and challenges of the risk-reduction technologies.

I suspect that like most of its positions on ... well, on everything, the United Church of Christ’s policy on condoms is purely political.

The UCC’s positions on condoms and everything else are purely political? I’m not sure what “purely political” means, but it sounds rather negative—e.g., insincere, manipulative, or opportunistic? Having just brought up the UCC Web site, I see plenty of denominational policies that I can support, and I see absolutely no problem with their promoting them. (E.g., support for victims of the Midwest flood surges, encouraging conversations on race, support for the recent Iowa court decision legalizing gay marriage, to name a few). To dismiss an entire Christian denomination’s policies on the grounds that they are “purely political” is not a very effective opener for one’s remarks about one of those policies. Not only does it pre-judge them, but it is an implied claim that one’s own motivations are entirely pure, i.e., not tainted by political considerations.

A lot of what churches do is designed to shape and disseminate a message. The UCC’s decision to distribute condoms at their services may have been intended for just such a purpose. It hardly matters whether UCC members are contracting AIDS or even whether they will use the condoms. What matters is that the UCC got into the news and became identified as a church that would like to destigmatize condom use. The very act of distributing the condoms had a destigmatizing effect, just as does their church’s welcoming and affirming stance toward gays.

What better way to publicize their policy than to conduct a condom distribution during their service? This may scandalize people whose ideas of a worship service are radically different, but these are differences we learn to live with when we enjoy religious pluralism.

The UCC’s policy is, in fact, based on sound science, such as the findings of the Centers for Disease Prevention and Control that Cheryl cited. Of course condoms are not going to work if they are not used, or if they are not used properly. I’m not aware that the UCC is promoting condoms as “the solution” to HIV contraction or that they are demoting abstinence. If you could find evidence that they are doing either of those things, then I could probably not advocate so enthusiastically on their behalf.

To dismiss an entire Christian denomination’s policies on the grounds that they are “purely political” is not a very effective opener for one’s remarks about one of those policies. Not only does it pre-judge them, but it is an implied claim that one’s own motivations are entirely pure, i.e., not tainted by political considerations.

With respect to the honorable provocateurs, Ms. M. and Mr. R., condoms are an apt symbol, too, that progressivist thinking assumes that the intent of the biblical writers - both in believing what they wrote to be true and truly representative of what the Incarnate said - is too hard, too difficult, too inconceivable in terms of what humans are actually like.

That the UCC has folded in terms of agreeing with the biblical writers, to say nothing of what Church tradition the birth place of the New Testament (Council of Hippo, Council of Carthage, 4th cent.), is merely to say that the UCC is more at-one with the spirit of our age in its ontological source than a stronger, more robust Body that does indeed believe in Scripture and Tradition, the Catholic Church.

Condoms, in short, are a failing attempt at a manageable retreat in the face of a (seemingly) relentless attack on human dignity, human love and life, human ontology and anthropology.

What better way to publicize their policy [the United Church of Christ's condom campaign] than to conduct a condom distribution during their service?

Doughlas,

Here's a better way: How about conducting a condom demonstration during a service? As you say, "...condoms are not going to work if they are not used, or if they are not used properly." Is it really enough to merely distribute them? Shouldn't those unfortunate UCC members who've never heard of condoms before be shown how to deploy them in an emergency? And what better time to do that than at a Sunday morning worship service?

As for the UCC "demoting abstinence," you must have missed the Sexuality Education page on their website. It features a large image of a zero-denominated dollar bill with the legend: "No More Money for Abstinence Only Until Marriage Programs." So much for promoting what actually works.

Hi. I hope you won’t mind if I join your discussion. It must be getting some notoriety, as I heard about it through my own faith network. I am impressed at how well the arguments flow toward greater and greater clarity about the condom issue. This is encouraging. I’ve studied communications and firmly believe that free and respectful discussion fosters understanding about issues that divide our world. I especially appreciate the deference that most of the writers show toward reason and evidence, as well as their ability to stay focused on the issue under discussion. The only exception would be the contributor who invoked Scripture and Tradition (with caps, no less). I found his comments very opaque, almost occultist. Scripture and tradition have been used over the centuries to justify so many horrors that I cannot understand invoking them in any serious discussion. Those are my two bits’ worth. Maybe I’ll check back later to see how things are going. Thanks.

I found myself only speculating, in my most recent comment, about the UCC’s motivations behind the dollar-bill ad. I got in touch with Ann Hanson, the UCC’s Minister for Sexuality Education and Justice, and asked her to throw some light on this for us. I hope she’ll join the discussion.

A condom demonstration during a church service? LOL. That would be a hoot, but I doubt it would be very effective. The UUC was probably hoping for optimal effect, not optimal scandal. Enough people are already scandalized at the mere thought of a condom. Demonstrating their use in a church service would be a little over the top at the present time. But who knows? Maybe in a few years... ;-)

I actually witnessed a condom demonstration in a sex education class in a church about 11 years ago. To avoid any further scandal, I won’t say which church it was. And I hope I don’t need to clarify that no live model was used. No follow-up study has been conducted as far as I know.

As for the UCC’s dollar bill, I am not ready to concede that the UCC is demoting abstinence. That would really surprise me. Instead, they may feel that the abstinence-only programs are ineffective when compared to condom promotion programs. Of course, the Bristol Palin story has been all in the news lately, so perhaps the folks at UCC can be forgiven for thinking that abstinence-only programs don’t work.

Gil Bailie and I are both members of the Colloquium on Violence and Religion and were both present at their annual conference last summer. I’ve been studying Rene Girard’s works since 1977 and have given talks and taught short courses on mimetic theory. Agent provocateur? Hardly. Gil and Randy have been gracious enough to publish dissenting views on their site, and so I keep returning to it, as I enjoy a good, robust discussion. I can’t speak for Ms. M. She may be a provocateur from one of those progressivist churches for all I know.

Mr. Gordon’s comment begs a very large question, and Mr. Remy may have been too timid in not pursuing it. The question is, “Do abstinence-only-until-marriage programs really work?” Obviously, the UCC’s Sexuality Education team must believe that they do not. Is there any science behind this belief?

Well, yes, from what I have been able to glean from a host of research abstracts and extracts published by the British Medical Journal. (Go to http://www.bmj.com, and search on “abstinence.”) I would recommend the first and the fifth items on the list, to begin with. The first one, entitled, “Sexual Abstinence-Only Programmes To Prevent HIV Infection in High Income Countries: Systematic Review,” concludes the following:

Programmes that exclusively encourage abstinence from sex do not seem to affect the risk of HIV infection in high income countries, as measured by self-reported biological and behavioural outcomes.”

If these programs do not work in high-income countries, they are unlikely to do so in the low-income countries of Africa.

The UCC’s policy is making more sense all the time. The U.S. is wasting 1.5 billion tax-payer dollars on programs that don’t work, and meanwhile, the Centers for Disease Control and Prevention finds that one in four teenage girls has a sexually transmitted disease.

I’m not finding any scientific research that disputes these conclusions. Advocates of abstinence-only programs are offering opinions based on folk-wisdom, religious belief, and tradition, all of which are notoriously unreliable in combating disease.

Thanks for the invitation, Doughlas. I had a response all typed up yesterday afternoon and somehow the message disappeared before it was posted.

I urge everyone to read the entire statement from the United Church of Christ's Aids Network:

http://www.ucc.org/news/uccs-health-advocates-press.html

A comprehensive approach to health and wholeness, including our sexual health, including medically-accurate and age-appropriate sexuality education, information on abstinence, sexually transmitted diseases and unintended pregnancy prevention, is the approach that has been affirmed by UCC General Synod Resolutions for over thirty years.

Many of our churches are providing age-span sexuality education.

There is good information on the Sexuality Education website: www.ucc.org/justice/sexuality-education/

One of our sexuality education facilitators has recently written an article that is available at the top of the aforementioned website.

Participation in our sexuality education programs is voluntary. Parents and youth, pastors and teachers who are using Our Whole Lives, widely affirm the importance of providing this education. Youth tell me that the education that they have received is the best thing the church has ever done for them. "It literally saved my life." "Don't ever stop doing this."

That the UCC has folded in terms of agreeing with the biblical writers...is merely to say that the UCC is more at one with the spirit of our age in its ontological source than a stronger, more robust Body that does indeed believe in Scripture and Tradition, the Catholic Church.Lloyd Davis, in his response to this comment from Athos, was alert to the problems of invoking scripture and tradition in a discussion about condom use. I would just add that arguments from the authority of scripture and tradition are always weak. When, looking for authority, you say, “Scripture says X,” any thinking person who knows her Bible may answer, “But scripture also says Y.” X and Y may be incompatible, or her implication may be that you believe X, why not also Y? Examples of Bible verses that contradict each other are too numerous to cite, as are examples of scriptural prohibitions and punishments that are now totally ignored by all but the criminally insane or the American fundamentalist Taliban. A related problem in invoking scripture is expressed in the question, “Which one?” Are we talking about the original Greek or Hebrew? The Old or the New Testament, or both? Are we including the apocrypha? It is well known that Jesus spoke Aramaic and that canonical translations of his words contain errors. When we cite the Ten Commandments, do we mean the version in Exodus 20 or the one in Exodus 34?

Catholic laity in the Middle Ages had an inordinate respect for scripture because priests gave it sacred status and kept it to themselves. Gutenberg and the various translators changed the rules of the game. We have come too far and we know too much to return to that ethos, and yet we almost daily hear preachers claiming “inerrancy” for the Bible. The Bible is of huge historical and anthropological importance. It was, after all, the first book written in an alphabet, it contains great literature, and it is the only “biography” of the Hebrew God that we have. (See Jack Miles’s brilliant book on this subject: “God: A Biography.”) But I would not look to it for guidance, much less authority, in questions pertaining to disease prevention.

The problems with tradition are similar. Whose traditions? At what moment in history? Traditions are constantly in flux. What was acceptable in Moses’ time was no longer acceptable to St. Paul. When Paul was writing to the churches in the eastern Mediterranean, slavery was the norm and women had such low status that he could instruct them to remain silent in church. Many, if not most, of the most odious practices in human history have been justified in the name of “tradition.” The fact that a custom has been “grand-fathered in” does not make it right. Fortunately, there are other standards for responsible moral judgment than either of the two that Athos cites.

Anyone who seriously believes in the authority of scripture and tradition is wasting his or her time in the free exchange of ideas that we find in this blog conversation. Absolutist thinking is intrinsically antithetical to the Internet medium, where ideas are constantly percolating through the system and spurious claims and religious or political certainties can be quickly challenged. Christians who claim the authority of scripture and tradition and yet cite scientific research in support of their moral positions are already giving ground. Opening up a subject like condom promotion for public discussion is a (welcome) abdication to reason and evidence. A strictly traditional approach, such as we might have seen 500 years ago in Europe, would crush dissent and silence voices like mine and several of the others who have commented here. All this is a sign that we have indeed come a long way, and we’re making progress.